Cerebral Fungal Infections in the Immunocompromised Host: A Literature Review and a New Pathogen—Chaetomium atrobrunneum: Case Report

Abstract

Cerebral abscesses in the immunocompromised patient may no longer be assumed to be caused solely by Aspergillus species. The literature reveals several rare cases of uncommon fungi found in these abscesses. Only four cases of cerebral infections caused by the genus Chaetomium have been reported. The case presented represents the first time a patient who had undergone a bone marrow transplant with a cerebral abscess was found to be caused by the pathogen C. atrobrunneum.

Diversity and taxonomy ofChaetomiumand chaetomium-like fungi from indoor environments

“…2011) and Am. atrobrunnea (= C. atrobrunneum , Guppy et al., 1998, de Hoog et al., 2013). These species, which grow in our living and working environment, deserve more attention in future.…”

“…Furthermore, Ch. globosum and several other Chaetomium species are reported as causal agents of onychomycosis or superficial infections (Koch and Haneke, 1965, Naidu et al., 1991, Aspiroz et al., 2007, Hubka et al., 2011, de Hoog et al., 2013), and some of them are capable of opportunistically causing deep or systemic infections (Hoppin et al., 1983, Barron et al., 2003, Guppy et al., 1998, Ahmed et al., 2016). …”

Black Molds and Melanized Yeasts Pathogenic to Humans

“…The significance of the genus has been underestimated because clinical strains are mostly sterile in culture, and could not be recognized by morphology . Clinically significant species include Chaetomium globosum, followed by Chaetomium strumarium, Chaetomium atrobrunneum, Chaetomium funicola, and Chaetomium perlucidum (Abbott et al 1995;Guarro et al 1995;Yeghen et al 1996;Guppy et al 1998;Lesire et al 1999;Thomas et al 1999). Chaetomium species have mainly been reported from onychomycosis and sinusitis (Aru et al 1997;Stiller et al 1992).…”

Airborne fungi in an intensive care unit

“…For example, related mycoses such as: disseminated pediculosis (Ye et al, 2015), mycotic endophthalmitis (Wu et al, 2011), intracranial aspergilloma (Mohammadi et al, 2015), cerebral aspergillosis (Bokhari et al, 2014), pulmonary scedosporium (Rahman et al, 2016), gastrointestinal aspergillosis (Koutsounas and Pyleris, 2015) between others diagnosis found in literature (Zahid and Farooqi, 2015;Borkar et al, 2008). This problem aggravates in immunocompromised patients, such is the case of hospitalized children with hypersensitivity related to the presence of the fungi inside the hospital (Beck et al, 2015;Libbrecht et al, 2015;Guppy et al, 1998).…”